“It really hurts to have sex,” I advised my physician. “Like, a lot.”

I used to be sitting in a hospital robe on the examination desk at my household practitioner’s workplace in Santa Fe, New Mexico. It was the identical desk the place I’d sat by each of my pregnancies and the place, three years earlier, I’d been identified with breast most cancers.

“I’m so sorry,” my physician mentioned. “I know how it feels to go through menopause. Especially since you went through it overnight.”

She was the one who identified me with most cancers. I’d discovered a small lump on my proper breast and known as her workplace instantly. Our appointment fell on Halloween 2017, and she or he was dressed up as Snow White, carrying full face paint and a black wig.

“You are one of the lucky ones,” she mentioned, as I sat on the desk and cried. “You don’t need chemotherapy, and you’re going to be okay.” My physician was proper — I used to be fortunate. I’d caught it early, and with breast most cancers, early detection is all the pieces.

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My remedy consisted of a mastectomy, reconstruction surgical procedure and 10 years of focused hormone remedy — to kill the estrogen in my physique and decrease my threat of recurrent most cancers. The aim of those hormone therapies — for pre-menopausal ladies — is to slingshot you thru menopause. It labored. Inside a matter of weeks, I went from being a wholesome 37-year-old menstruating girl, to a hot-flashing, bone-aching, post-menopausal most cancers survivor. I suffered vaginal irritation, one thing I’d later be taught was vaginal atrophy. The one factor not atrophying have been my post-operative breasts — they seemed perkier than ever. However whereas my boobs felt 16 once more, my vagina felt 61. It was a complete mindfuck.

“It hurts,” I complained. “Just… all the time. And especially during sex.”

“Menopause makes it very uncomfortable — nearly impossible — to have successful intercourse,” she mentioned matter-of-factly. “Have you heard of vaginal rejuvenation? A colleague of mine, in Albuquerque, is offering laser treatment in her practice. I think you’d be a great candidate for it.”

An hour later I used to be house, googling laser vaginal rejuvenation. Finally, I discovered a good ladies’s healthcare website with data on the remedy. Above the medical description, there was a photograph of a smiling girl in her 60s, carrying a pink button up shirt. She had carried out the therapies and gave the impression to be having fun with “successful intercourse.”

The kind of vaginal rejuvenation remedy I used to be contemplating, “gently rejuvenates” the vagina, by delivering a kind of remedy generally known as fractional CO2 (carbon dioxide) laser power to the gentle tissues of the vaginal wall and offering a hormone-free remedy for vaginal atrophy. Vaginal atrophy — for individuals who haven’t but journeyed into the Saharan desert of menopause — is next-level vaginal dryness. It’s a facet impact of menopause — virtually a assure. For a lot of ladies and other people with vaginas, vaginal estrogen lotions can present adequate reduction for the ache skilled throughout intercourse attributable to vaginal atrophy. For ladies like me — who’re proactively killing the estrogen inside their our bodies with mega medicines — the analysis stays ongoing about estrogen lotions, rings and tablets, and whether or not they’re secure to make use of. Proper now, it’s not one thing I’m comfy with.

I used to be excited to debate what I’d realized with my husband. Within the throes of parenting two toddlers — whereas additionally recovering from a life-threatening sickness — addressing sexual dysfunction was on our to-do listing however hadn’t but turn out to be a disaster in our marriage. Collectively we outlined two main drawbacks to the remedy. The primary was the worth tag. The laser remedy consists of three periods, distanced a couple of months aside. I used to be quoted $3,000 in whole for the three periods. Insurance coverage doesn’t cowl the price of vaginal rejuvenation, though you would possibly be capable of get reimbursed by a versatile spending account (FSA). I don’t have a type of.

The second concern was the danger. Many of the web sites I researched didn’t point out any threat concerned with the remedy. However there may be, after all, threat whenever you resolve to have your vagina lasered. Some ladies have skilled excruciating ache through the remedy and — in very uncommon circumstances — suffered vaginal burns. Regardless of all that and since I used to be one of many fortunate ones to have entry to the remedy and will afford it, I made a decision to strive it.

A number of weeks later, I used to be taking within the desert mesas on my method to Albuquerque for my first laser remedy. Once I arrived on the small gynecology observe, I used to be greeted by a younger and chipper receptionist. I advised her in a quiet voice that I used to be there for vaginal rejuvenation. She requested me to repeat myself. I did. She giggled nervously and requested me to attend. I watched her seek the advice of with a co-worker earlier than returning to the window. “I’m sorry,” she mentioned with amusement. “I hadn’t heard of that before.” I shot her a glance that was meant to say, menopause is coming for you too, younger girl.

Finally, I used to be led to an analyzing room and given a robe. A nurse entered the room and utilized a numbing cream to my labia. As I waited to go numb, I noticed the laser remedy within the nook of the room. It was a tall machine with a protracted, slender wand. It seemed like one thing you would possibly see at a dentist’s workplace. Then the gynecologist walked in — an older, soft-spoken, hippy-ish girl — and advised me how excited she was to have the chance to carry out the remedy. “Have you used the laser before?” I requested nervously. “Only a few times,” she responded. I attempted to disregard the sudden wave of panic that washed over me. She turned on the machine and it made a loud, vibrating noise. As I laid again, a tagline from an outdated Virginia Slims industrial popped into my thoughts: You’ve come a good distance, child.

The preliminary remedy went effectively. For a couple of days, I skilled some gentle vaginal bleeding, which was to be anticipated. The laser creates tiny micro-abrasions on the vaginal wall, rising blood move and stimulating the expansion of recent blood vessels — primarily bringing new life to your vagina. I didn’t really feel any ache through the remedy, though it was a bit uncomfortable and awkward. After the primary session, I seen one thing straight away. My vagina appeared happier. In actual fact, it didn’t harm ― in any respect.

My gynecologist advised me to have intercourse in-between the periods, to assist preserve my new elasticity. I used to be feeling so bolstered from the constructive outcomes of the primary remedy, I couldn’t wait to leap into mattress with my husband. However when it got here time to get right down to enterprise, I used to be extraordinarily disillusioned to search out out penetration remained very painful.

“I’m sorry,” I mentioned to my husband, after we tried — unsuccessfully — to have intercourse. “I can’t do this, it hurts too much.” I used to be in tears. We each have been annoyed. Would I ever have intercourse once more?

I introduced this query to my subsequent appointment in Albuquerque. My gynecologist advised me to attend to complete all three therapies earlier than coming to any conclusions. However the outcomes from the second remedy weren’t all that noteworthy. And the identical was true for the third and ultimate remedy. It appeared to me the main advantages of vaginal rejuvenation occurred after the primary remedy. It had a really constructive impact on the general wellbeing of my vagina however didn’t repair the painful signs I used to be experiencing throughout intercourse.

Six months after my preliminary physician’s go to, I used to be again within the analyzing room detailing my expertise. My physician and I agreed that researching and devoting extra funds to ladies’s well being has a protracted method to go. Most girls can’t afford costly vaginal laser therapies, and as a substitute, are studying to normalize their ache or just keep away from speaking about it.

Did vaginal rejuvenation repair the painful signs I skilled throughout intercourse? No. Do I really feel comfy utilizing an estrogen cream? Once more, no. However I consider the ready room on the Dana Farber Most cancers Middle — and I assume I can dwell with it. The query is, why ought to I? Why is there somewhat blue capsule for erections and never an efficient remedy for vaginal dryness? But once more, it appears we’ve been given the shaft.

Earlier than I left, my physician wrote me a prescription for Lidocaine, a numbing cream.

“Put this on twenty minutes before sex, it really helps,” she mentioned. Earlier than she left the room she turned and gave me a half smile, as if to say, welcome to menopause, we’ve come a good distance, child. However have we?

There are a couple of different non-estrogen vaginal atrophy therapies on the market — and possibly sometime I’ll strive them. For now, my companion and I are exploring what “successful intercourse” means to us. Penetration is just one approach of getting intercourse — there are many enjoyable issues to do.

After I used to be catapulted into menopause, we have been compelled into these awkward however finally fruitful discussions ― and in some ways, they’ve introduced us nearer collectively. We’ve redefined what intercourse and intimacy appear like to us — and that looks like successful.

The essay initially ran in November 2022 and we’re publishing it now as a part of HuffPost Private’s “Best Of” collection.

Anna Sullivan Reiser is an writer and psychological well being therapist. She writes for The Insider and is co-host of the upcoming podcast “Healing + Dealing,” which shines a highlight on younger survivorship points. She lives in Santa Fe, New Mexico, together with her husband and two youngsters. You may contact her at annasullivanreiser.com or observe on instagram @healinganddealingpod.

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